Should we all take pills?

The desire to take medicine is perhaps the greatest feature which distinguishes man from animals.Dr. William Osler

Worldwide so many people are on some kind of pill. Are you on a pill and for what? I am so happy I don’t have to take a pill for anything. I just spent this past weekend at the hospital with my dad. He has congestive heart failure, type II diabetes and hypertension. Before going home, he was prescribed more medication to add to his list. On his list of medications, three of them treat the symptoms of his conditions and the other four are treating the contraindications of the medications. Why is there a need for so many pills and should we hold fast to the pill? Are we giving the pill more power than it deserves in our lives?

Are pills really that effective?

Let’s look for an answer together in a book by Dr. Jerry Avorn "Powerful Medicines". He suggests in his book: “When a new drug is first marketed little is proven about its’ safety and effectiveness compared to existing alternatives, and the situation is often no clearer years or decades later. We have a limited capacity to identify side effects early and reliably, and when a potentially fatal adverse event is detected it may take so long to enforce a recall that thousands of additional patients are put at risk.”(p.72) Dr. Avorn makes a very good argument here about the limited research done on new drugs. In addition, the side effects of some drugs are almost effective immediately as the time release. For example, the drug propofol, now known as the “Michael Jackson Drug” can be fatal. In Michael Jackson’s case it was. I do not know if Michaels’ life would have been saved, if the medics were called sooner than they were. I do believe that Michaels’ doctor should have been more careful or avoided the use of a potentially dangerous drug .

Dr. Avorn recalls what happened with the weight loss drug when he says, “Fenfluramine resurfaced with a vengeance in the second half of the 1990s after a therapeutic-image makeover. The drug’s stature was transformed when a pharmacologist discovered that it if was taken together with another not terribly effective pill, phentermine, the two could act synergistically to produce somewhat greater weight loss. The number of pounds shed remained modest and the weight came back when the drugs were stopped, but this dual action property was enough a hook to give the combination new appeal in an overfed, underactive nation.”(74) I really see what Dr. Avorn means when he says this. When I go to the fitness center on Saturday mornings, I hear people talking about their medications. I heard one person asking his trainer if he could cut back on exercise because he is on a new weight loss pill that allows him to eat whatever he wants. Seriously, we have to set a better example when it comes to being active and eating less so we do not have to take unsafe medication. I also remember when this drug became known as “fen-phen” and sad to say that this cocktail of fenflurimine and phentermine became a cause for serious concern. At one point in my career, I was an adviser for a pharmacy. When some the patients would come in to pick up their drug cocktails, you would think they were at the candy store! I know that when you start counting out the pills they look nice and pretty, but the pharmacy is not the candy store. These chemical medications have potent and sometimes irreversible contra indications. Dr. Avorn is trying to help us see the problems and costly risk involved with Prescription medication. I personally do not see much benefit as Dr. Avorn did include in his writings. In my opinion, free of cost to you, the only thing that should be prescribed today is placebos. I believe in preventive health directives and that we should avoid taking as many prescription drugs as we possibly can.

Dr. Avorn continues to enlighten us on the red tape involved in solving the problems of the prescription drug system when he recalls the risk of Rezulin. Rezulin has proven to put the “R” in risk. There was a diabetic study done in 1997. Several patients enrolled. According to Dr. Avorn, MD “Near the end of 1998, another patient enrolled in a different company sponsored Rezulin study developed rapid onset liver failure despite regular monitoring; within a month she was dead. But over 2,600 other patients throughout the country were still participating in the study.”(p.92) It was typical that the company’s scientist opted out of releasing the case because of so called “defending the molecule.”(p.92) I do not think we should take this case lightly because one death is one too many. There were some hospitals that were smart enough to stop prescribing the drug before the FDA. The FDA passed a decision to keep it on the market for use. I am not willing to bank on a drug that may result in a premature death. Damage of chemically processed drugs can set on quickly without the knowledge of the patient, especially if it is fatal. Many companies think that they have safety in numbers. That is not a good enough reason to call a drug safe. It is so sad to read about young mother’s having to put their unborn children at risk of birth defects because of taking prescription medication.

The most vulnerable patients, the elderly, at the center of Dr. Avorns arguments, are mentioned when he says, “Problems in medical education make a bad situation worse. Practical clinical pharmacology and geriatrics both receive inadequate attention in most medical schools, even as the use of medication in older patients becomes more and more central to the work of nearly all physicians.”(p.134) News like this hits too close to home for me having recently lost my grandmother. She had a shopping bag full of prescription medication that she had no desire to keep taking. I hope to keep living a long time myself without a shopping bag full of medication.

I truly enjoyed reading Dr. Jerry Avorns’ book Powerful Medicines. I would advise others to consider his innovative suggestions on how the system should be corrected. We have to acknowledge the problems with prescription drugs in order to correct them. God knows we need an All New Health Care Makeover.

Reference:
1. Avorn, MD, Jerry. Powerful Medicines. The Benefits, Risk, and Cost. First Vintage Books Edition, August 2005. New York

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